Andrew Heartman, 47, is one of four male surrogate partners in the Bay Area (surrogatepartner.us). A former software engineer, he lives in Union City with his girlfriend of 6 1/2 years.

Once known as sex surrogates, surrogate partners help clients to overcome the emotional blocks that result in sexual dysfunction and fear of intimacy. Using sensuality exercises to gradually build trust and acceptance, the surrogate works to impart the skills necessary to build a relationship.

When I was a software engineer I could tell people what I did and they would have a pretty good idea about what that meant. But if I tell someone that I'm a surrogate partner, they either have no idea what I do or the ideas they have are incorrect.

Some people think that an important part of it is being a master of sexual technique, whereas that is really irrelevant.

I participated in an online discussion group a few years back. There were a lot of misconceptions and accusations going on about it. So I stepped in and said, "I'm a surrogate partner; and what this work is about, at least as I see it, is mostly about helping people acquire skills that support their having a more intimate, connected, passionate life."

I basically was saying that very little of the work is sexual. There was a survey that said surrogates spend maybe 10 to 15 percent of their time in activities that could be considered sexual. Most of the time it's about communication and relaxation and relearning how to touch and build trust.

I thought I gave a really great explanation. And yet, the next response was someone coming back and saying, "Looks like prostitution to me."

I did my training in 2008 with IPSA (International Professional Surrogates Assn., surrogatetherapy.org.). It's a 12-day intensive training which is part of the certification process. After you complete the training, you become an intern; and I'm currently in that stage.

All of my clients are referred by a psychotherapist. The sessions are generally an hour and a half and maybe we'll go to two hours later on. The clients I've seen are in their 40s, 50s and 60s.

It's difficult to get started in this work. First of all, surrogate partner therapy is somewhat controversial, even in the therapeutic community. And second, many people have the idea that surrogate partners are all female.

There's a couple of important differences between male clients and female clients. With male clients, I think they typically come in with a complaint about something related to sexual performance. With female clients, there's other things going on like negative body image, fear of failure, fear of intimacy. Those are always going on for male clients as well; it's just a matter of the proportion.

Also, many female clients have trust issues because of bad experiences they've had in the past. Trauma or abuse. So it's really important to create an environment of safety and acceptance.

The pacing is really different with women. In general, I've found that because it's more important to create that environment of safety and acceptance, the work proceeds more slowly. In "The Sessions," for example, you see Cheryl (Cohen Greene) going to full nudity in the first session. I've had times where I would reach in session No. 12 what Cheryl might reach in session No. 1 or No. 2

My girlfriend is extremely supportive of my doing this work. In fact, I told her of my intention to become a surrogate on our first date. I thought she would run away screaming and never want to see me again. But instead, she started telling me all the reasons why she thought from her perspective that I'd be good at it. And we've been together ever since.